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  Comments/Feedback  
 
We appreciate your comments and feedback about our service and your compounded
prescription(s).
 
   
   
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Is there anything we can improve?
Can we provide any additional service to better meet your needs?

Comments about your compounded prescription(s)

Please enter the Rx#, then answer any questions that apply to that prescription.

Rx#

 
Did you have any problems with administration?

No         Yes         If yes, please explain.

   
Did we explain how to use your medication clearly?

No         Yes        If yes, please explain.

Do you like the consistency and/or flavor?
Do you have any questions about your therapy?
 

Rx#

 
Did you have any problems with administration?

No         Yes        If yes, please explain.

   
Did we explain how to use your medication clearly?

No         Yes        If yes, please explain.

Do you like the consistency and/or flavor?
Do you have any questions about your therapy?

(Type the 5 character code in the above field.)
Can't see the code clearly?
 
   
651 Topeka Way, Suite 600, Castle Rock, CO 80109
(303) 663-4224    fax (303) 217-5054
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